| NPI | 1699178343 |
|---|---|
| Former Name | JENNIFER LEE GREGORY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024171752) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001215163) |
| Enumeration Date | 2014-10-08 |
| Last Update Date | 2016-05-16 |